Recreational use of HIV antiretroviral drug linked to psychoactivity

More than one in 270 people in the U.S. are living with HIV, and every 9.5 minutes someone is else is infected. The economic cost estimates associated with HIV/AIDS exceed 36 billion dollars a year. Effective antiretroviral (ARV) drug treatments have helped people with HIV to live longer. However, a highly effective and widely prescribed antiretroviral drug, efavirenz, can also cause adverse neuropsychiatric side effects including depression, anxiety, aggressive behavior, night terrors, hallucinations, psychosis and delusions. Recently efavirenz has been diverted for recreational use when the pills are crushed and smoked for a high.

John Schetz, PhD, Associate Professor of Pharmacology and Neuroscience, recently applied his expertise to help solve the mystery as to why efavirenz, when taken as prescribed, can cause adverse neuropsychiatric events, and why it may be attractive for recreational use. This later use is a potential public health concern because improper dosing could encourage the development of ARV-resistant HIV strains.

Dr. Schetz and colleagues hope their findings will help generate support for additional studies aimed at preventing ARV side effects and abuse. Re-engineering a highly effective ARV drug that lacks adverse neuropsychiatric side effects and abuse potential could foster patient compliance, reduce the likelihood of HIV drug resistant strains and prevent illicit use of HIV medications.